Failed CPAP, APAP, now on to BiPAP... help please!

[slowriter]

Thank you for this. Per their titration protocol, I have simply been raising minimum pressure to get rid of the cluster of obstructive apneas that I get during REM sleep. In January I started at a minimum pressure of 7.0 and have been slowly increasing it, but the obstructive apneas still remain. This is why I hesitate to go back to lower pressures... I already know that they don't do anything for my REM OA's.

After the OA's go away, then I will start increasing PS to get rid of RERA's, provided I don't start causing central apneas.

This makes sense, right?

Right.

I don't agree with mper's recommendations. You yourself say, effectively, that you already have data that shows you get OAs at lower min EPAP.

[Sleeprider]

Put me third in line to say Mper is off on this recommendation to start titration at 4. I don't agree.

[UARS.DDS]

   

EPAP 15.2, PS 4.0 and I'm liking what I'm seeing!

I'm going to start bumping up PS slowly now.

[70sSanO]

How do you feel?

If this has improved your sleeping, you may want see how these settings work out over the next few days and see if the numbers settle down as you adjust to them. It is easy to lose sight of what is really working with daily changes.

Your leaks are high, but with the higher pressure that happens. Otherwise your numbers look good.

John

[SarcasticDave94]

I'd agree, maybe ride this a couple of days to see what trends you get. If you have a complaint to fix, that's different than trying to get 0 AHI. What is it that you didn't like?

[UARS.DDS]

Definitely not chasing numbers. I’m going by how I feel, and I’m having an easier time getting up in the morning and feeling better throughout the day, but it’s still not where I want to be. 

I’m paying some attention to changes in ventilation rate, and am hoping to reduce those spikes by decreasing flow limitations.

[holden4th]

Getting to where you want to be may take a while. While this hasn't been conclusively proved, the concept of sleep debt has many followers and my xPAP experience lends credence to this theory.

It took me a while (a couple of months) to get my numbers right yet initially I didn't really feel that much better in the morning. The improvement was noticeable but it wasn't significant. Then can came the epiphanal moment. I got up and as I was driving to work I gradually realised that I was feeling the best I'd ever been for a long time. That was the day when I knew that the therapy worked for me. Did I feel the same way the next morning, no way Jose but it was better. 

I felt that after my numbers got onto the right track I still had some residual fatigue. This has diminished over the last couple of years. However, even now I am capable of 10+ hours sleep as my body recovers its sleep debt.

Hopefully, this will be the outcome for you.

[slowriter]

While this hasn't been conclusively proved, the concept of sleep debt has many followers and my xPAP experience lends credence to this theory.

One of the disconcerting arguments of Matthew Walker's newish book "Why We Sleep" is that current neuroscience concludes the "debt" model doesn't actually hold; that we never recover lost sleep.

But clearly getting more and better sleep should mean feeling better.

[holden4th]

While this hasn't been conclusively proved, the concept of sleep debt has many followers and my xPAP experience lends credence to this theory.

One of the disconcerting arguments of Matthew Walker's newish book "Why We Sleep" is that current neuroscience concludes the "debt" model doesn't actually hold; that we never recover lost sleep.

But clearly getting more and better sleep should mean feeling better.

I might put that book on my reading list. Thank you.

This is worth watching and sort of validates why xPAP treatment is so important to us.

https://www.youtube.com/watch?v=5MuIMqhT8DM

[UARS.DDS]

Hey all!

Been a while since my last update. 

I've gradually titrated up to an EPAP of 16.2 which, in combination with the Knightsbridge dual chin strap, has eliminated obstructive apneas. I find the chin strap to be more comfortable than a neck brace.

Switching to the ResMed N30i from the P30 has allowed me to move around in bed without getting the hose tangled around my neck.

Using Lansinoh has eliminated large leaks.

My anxiety is pretty much gone, headaches are gone, need to nap during the day is gone, but I still have difficulty getting up in the mornings and do have fatigue during the day.

I don't know how "right" or "wrong" this is, but as a loose way of tracking RERAs I've been looking at spikes in minute ventilation correlating with flow limitations. I'm hovering at around 30-40 per night, putting my RDI at about a 5, which is a great improvement from the RDI of 13 I was at with my WatchPAT study last year. I'm going to start increasing PS slowly.